Provider Demographics
NPI:1972607513
Name:PARISH, LINDA ANN (RN NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:PARISH
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 FIELDSTONE LN
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-9608
Mailing Address - Country:US
Mailing Address - Phone:847-683-9851
Mailing Address - Fax:
Practice Address - Street 1:4940 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2270
Practice Address - Country:US
Practice Address - Phone:815-227-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-138211163W00000X
WI142938-030163W00000X
IL209-004285363L00000X
WI2181363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse